Department of Pathology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Cancer Genomics Proteomics. 2022 Jul-Aug;19(4):526-539. doi: 10.21873/cgp.20338.
BACKGROUND/AIM: Uterine mesonephric-like adenocarcinoma (MLA) is a rare malignant tumor of the female genital tract.
We reviewed 237 endometrial carcinoma cases and investigated the clinicopathological and molecular characteristics of uterine MLA.
We found that 3.0% (7/237) of the endometrial carcinoma cases were MLAs. Compared to endometrial endometrioid carcinoma, MLA showed larger tumor size, deeper myometrial invasion, increasingly advanced-stage disease, and more frequent lymphovascular space invasion. All MLAs exhibited architectural diversity, compactly aggregated small tubules, eosinophilic intraluminal secretions, overlapped and angulated nuclei, scant cytoplasm, and presence of spindle cells. All the MLAs expressed at least two mesonephric markers. All except one MLA harbored activating Kirsten rat sarcoma viral oncogene homolog mutations. All patients with MLA developed postoperative metastases. MLA had the lowest progression-free survival rate among different histological types of endometrial carcinoma.
Uterine MLA is a highly aggressive gynecological malignancy, showing unique morphological and molecular features, frequent recurrences and metastases, as well as poor prognosis.
背景/目的：子宫中肾样腺癌（MLA）是一种罕见的女性生殖道恶性肿瘤。
我们回顾了 237 例子宫内膜癌病例，并研究了子宫 MLA 的临床病理和分子特征。
我们发现，3.0%（7/237）的子宫内膜癌病例为 MLA。与子宫内膜样腺癌相比，MLA 表现出更大的肿瘤大小、更深的肌层浸润、更晚期的疾病分期以及更频繁的淋巴管血管间隙浸润。所有 MLA 均表现出结构多样性，紧密聚集的小管、嗜酸性腔内分泌物、重叠和成角的核、稀少的细胞质以及梭形细胞的存在。所有 MLA 均至少表达两种中肾标记物。除 1 例外，所有 MLA 均携带激活的 Kirsten 大鼠肉瘤病毒致癌基因同源突变。所有 MLA 患者在术后均发生转移。MLA 在不同组织学类型的子宫内膜癌中具有最低的无进展生存率。
子宫 MLA 是一种高度侵袭性的妇科恶性肿瘤，具有独特的形态学和分子特征，频繁复发和转移，以及不良的预后。
